Cardiovascular disease (CVD) is the leading cause of death among Hispanics. They have a disproportionate cardio-metabolic risk burden compared to any other ethnic group, which combined with other physiological, biological, and psychosocial stressors, contribute to disparate heart health. Positive changes in CVD morbidity are largely attributed to lifestyle practices. However, health promotion strategies have focused merely on individuals with limited long-term success. In order to influence health behavior change and promote sustainable healthy lifestyles, a socio-ecologic approach of health promotion is needed to influence behavior at the individual, social, cultural, and environmental levels. Therefore, we propose to conduct a participatory community-based intervention to intervene on each of these multiple levels that influence health behavior in Puerto Rican adults (45-60 years). We target Puerto Ricans because they represent the second largest Hispanic sub-group in the US. We have documented, through current work fi-om the Boston Puerto Rican Center on Population Health and Health Disparities, a constellation of sociodemographic, biological and psychosocial factors that place this population at a greater risk than other groups. We hj^othesize that participatory research and community engagement wall help develop and implement an effective multi-level Heart Healthy Action Program (HAP). HAP development vnll be informed through focus groups and key informant interviews. Program components (nutrition, physical activity, stress/anxiety reduction and social support) wdll be addressed by multi-level activities (individual, social, cultural and environmental). HAP health behavior messages and counseling will be re-enforced through innovative technology using computer-participant working alliances. We have assembled a trans-disciplinary team of experts in nutrition, physical activity, psychology, computer science, social science, epidemiology, public health and medicine, who plan to work jointly to address heart health disparities among under-served disadvantaged Puerto Rican adults living in the Metro-Boston urban area. Our long-term goal is to create an effective and sustainable heart health promotion program that could be implemented broadly in populations at risk.

Public Health Relevance

This participatory research in partnership with the community includes role modeling, social support, and capability building. The objective is to develop, implement and test a heart healthy action program (HAP) for Puerto Rican adults (45-60 y) to influence health behavior at multiple levels (individual, social, cultural and environmental). We believe successful implementation of HAP will have a significant public health impact

National Institute of Health (NIH)
National Heart, Lung, and Blood Institute (NHLBI)
Specialized Center (P50)
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Special Emphasis Panel (ZCA1-SRLB-3)
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University of Massachusetts Lowell
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